If you got stuck with a high deductible health insurance plan, you’re not alone: 39 percent of us (under age 65) have a plan with at least a $1,300 deductible. For years, I had a plan with a whopping $8,000 family deductible. You’re not totally screwed, though. You can still get care without breaking the bank, if you know a few tricks.

High deductible plans are becoming more common as health care costs rise. An insurance company can raise their deductible instead of raising their premiums, and that makes your insurance look cheaper. It’s actually a pretty good deal if you’re healthy enough and lucky enough that you never rack up huge bills.

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If you do need to use the health care system, having insurance still helps because your insurance company negotiates better rates than you’d get if you pay cash. I once got a bill for $2,000 that had been knocked down from $42,000 without any money changing hands. Still, having a high deductible sucks, and here’s how you can survive it.

Take Advantage of Preventive Care Freebies

Don’t think you have to stay away from the doctor if you want to save money. Your insurance plan is required to give you certain types of preventive care and medications for free—that means no copay, and without touching your deductible.

That means you can get vaccines, cholesterol screenings, birth control, and more without paying a cent. Check with your insurance plan about the details; you’ll have to go to an in-network provider, and in some cases there might be an office visit fee. But, by law, all non-grandfathered health plans must provide these freebies. And taking advantage of them will help you keep control of your overall health, which is good for your body and your wallet in the long run.

Pay Into a Health Savings Account

A health savings account, or HSA, is a tax-free emergency fund for medical expenses. If you have a high-deductible plan, you’re eligible to open this type of account, and you (or your employer) can contribute to it as part of your paycheck.

Don’t confuse the HSA you need with a flexible savings account (FSA), which has a lot more restrictions. The HSA we’re talking about has two serious perks:

You don’t pay taxes on the money you put into (or take out of) an HSA. That’s equivalent to a steep discount on your medical expenses.

The money in an HSA is yours forever. It stays in the account at the end of the year, unlike the money in an FSA. It stays in the account even if you change jobs or insurance plans. It is your money. If you don’t end up using it for medical expenses, you can withdraw it tax-free if you become disabled or when you retire.

Ideally, you’ll budget for regular contributions to your HSA. Then, when you start getting medical bills, the money will be sitting in your account ready to go.

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The downside is that if you sign up in January, and then break your leg in February, you won’t have much money in your HSA to start covering costs. In that case, you’ll have to dip into your regular emergency fund, or talk to the hospital about a payment plan. But if you manage to save a whole deductible’s worth of money and you don’t end up needing it, that money will still be in your account next year.

Know Your Cheapest Options for Care

As tempting as it might be, don’t forgo care that you really need. It’s unfortunate that sometimes we have to choose between our wallet and our health, but use your best judgment and be smart about it. Here are a few things you can do right now to help make that choice easier:

Buy an ambulance subscription. In my area, paying $50 up front buys as many free ambulance rides as you need (otherwise $700 a pop). That works out to just $4 a month, and makes it way easier to pick up the phone when it’s time to call 911.

Find a telemedicine service that works in your area. Each company only operates in certain states. If you’re not sure whether something requires an in-person doctor visit, a telemedicine call can be a cheap and easy way to find out. A typical call is around $40 with little to no wait time.

Check your insurance company’s services. They may have a free hotline staffed by nurses, or a discount on telemedicine.

Throughout your journey through the medical system, remember that you can always ask for a price, and say no if it’s too much. For example, if your doctor recommends an extra test or procedure you weren’t expecting, ask about cost—and ask if it’s really needed. Sometimes there is another option that is cheaper or almost as good.

For example, when I took my kid to the doctor for his (free) well visit, I showed the doctor a rash that he had, and mentioned that we had been treating it with an over-the-counter cream. That works, she said, but as a favor she wrote us a prescription for a different cream that “sometimes works a little better.” When I went to the drugstore to pick it up, the cashier told me it would cost $200. No thanks, I said, and walked away. (Yes, you can do that!) We kept using the over-the-counter cream and the rash cleared up just fine.

You’d be surprised at the answers you get when you ask if a test or medication is really necessary—and a good provider will discuss your options honestly. Life on a high deductible plan can be difficult, but you don’t have to fear seeking care.